Content That d!gger Likes

After circling the drain with compassion fatigue, I stumbled upon this article that was published in the ACEP: read it and tell me you don't feel proud!

Guest Editorial
ACEP News
September 2006
By David F. Baehren, M.D.

For a generation or two, we have lamented the loss of role models in society.

As parents and individuals, we naturally seek out others we would like to emulate. Sadly, a serious search through the popular culture leaves us empty-handed and empty-hearted. Thanks to a long list of legal and moral shenanigans, many entertainers, politicians, and athletes long since abdicated this momentous position of responsibility.

We usually look afar for heroes and role models, and in doing so overlook a group of professionals who live and work in our midst: nurses.

And not just any kind of nurse: the emergency nurse. There are plenty of people involved in emergency care, and no emergency department could function without all of these people working as a team. But it is the emergency nurse who shoulders the weight of patient care. Without these modern-day heroes, individually and collectively we would be in quite a pinch.

This unique breed of men and women are the lock stitch in the fabric of our health care safety net. Their job is a physical, emotional, and intellectual challenge.

Who helped the paramedics lift the last 300-pound patient who came in?

Who took the verbal lashing from the curmudgeon giving admitting orders over the phone?

Who came to tell you that the guy you ordered the nitro drip for is taking Viagra?

The emergency nurse has the thankless job of sitting in triage while both the long and the short buses unload at once. With limited information, they usually send the patient in the right direction while having to fend off some narcissistic clown with a zit on his butt. They absorb the penetrating stares from weary lobby dwellers and channel all that negative energy to some secret place they only tell you about when you go to triage school.

Other kinds of nurses serve key roles in health care and attend to their patients admirably. However, few function under the gun like emergency nurses do.

It is the emergency nurse who cares for the critical heart failure patient until the intensive care unit is "ready" to accept the patient. The productivity of the emergency nurse expands gracefully to accommodate the endless flow of patients while the rest of the hospital "can't take report." Many of our patients arrive "unwashed." It is the emergency nurse who delivers them "washed and folded." To prepare for admission a patient with a hip fracture who lay in stool for a day requires an immense amount of care--and caring.

Few nurses outside of the emergency department deal with patients who are as cantankerous, uncooperative, and violent. These nurses must deal with patients who are in their worst physical and emotional state. We all know it is a stressful time for patients and family, and we all know who the wheelbarrow is that the shovel dumps into.

For the most part, the nurses expect some of this and carry on in good humor. There are times, however, when the patience of a saint is required.

In fact, I believe that when emergency nurses go to heaven, they get in the fast lane, flash their hospital ID, and get the thumbs-up at the gate. They earn this privilege after being sworn at, demeaned, spit on, threatened, and sometimes kicked, choked, grabbed, or slugged. After this, they go on to the next patient as if they had just stopped to smell a gardenia for a moment.

Great strength of character is required for sustained work in our field. The emergency department is a loud, chaotic, and stressful environment. To hold up under these conditions is no small feat. To care for the deathly ill, comfort suffering children, and give solace to those who grieve their dead takes discipline, stamina, and tenderness. To sit with and console the family of a teenager who just died in an accident takes the strength of 10 men.

Every day emergency nurses do what we are all called to do but find so arduous in practice. That is: to love our neighbors as ourselves.

They care for those whom society renders invisible. Emergency nurses do what the man who changed the world 2,000 years ago did. They look squarely in the eye and hold the hand of those most couldn't bear to touch. They wash stinky feet, clean excrement, and smell breath that would give most people nightmares.

And they do it with grace.

So, here's to the emergency nurse. Shake the hand of a hero before your next shift.
DR. BAEHREN lives in Ottawa Hills, Ohio, and practices emergency medicine.

This has crossed my mind as well. Difference = disorder to some people. Especially in the school setting where I work, I have seen people equate learning differences as learning disabilities, and that concerns me. Instead of making the effort to teach in a different way, they want to medicate.

I am not saying that there are not disorders that require and benefit from medical treatment, but not every child who learns things differently from "the norm" (whatever that is) needs to be on medication.

I am not beating up the nurse manager, thank you very much for you insensitivity, and false accusation!! I am not that type of a person, and before you go accusing me, sounds like you are a professional at business hiring. I was not iquiring about your expertise perhaps in another are than nursing.

Lex, I'd like to add some thoughts here, if you're willing to listen to them? I'm not going to jump on you, but I'm also going to disagree with you--respectfully--so would appreciate the same response. Message boards are funny places; we can't see each other's expressions and sometimes we misread what the other person has written, because of HOW it's written, so that's what we go on. What you might think of as just honest venting might come across as cautic or rude to someone else. And the same goes back and forth: you might take what someone writes in response to your statement as rude or insensitive, and that's not how it was intended. So, there's my note of caution about posting on a public message board

Yes, maybe they NM ought to take a pay cut as well, it does not take 6 MN (one for each floor) to hire nurses to fill a hospital.

Well, actually, it usually DOES take all those nurse managers to hire for different departments. Each department does work differently than another, and the professional needs and desired personalities will differ, too. My nurse manager might choose Nurse A for her unit when another nurse manager has rejected Nurse A. And vice versa. So no, I don't think it's a good idea to have one person in charge of hiring for an entire hospital's worth of nursing departments.

Not more than it takes to hire someone with 3 years experience for the ICU compared to a new graduate, becuase they are training us really well here at the university, and there are a lot of us who are a lot more smarter than some nurses in the hospital now. Yes, that is right, we are being taught and are getting hands on the most updated nursing concepts and training there is. So, take that to your NM.

Please be careful; this attitude, if it presents itself during the hiring process, is a sure-fire application killer. YOU might feel you are "a lot more smarter" than the nurses currently on staff, but I guarantee you the person hiring you won't be so predisposed to your way of thinking. The attitude that you've just learned--paraphrased--'all there is' because you've just graduated is not only a slap in the face of those with TONS of experience, but also incorrect. You've learned whatever your program decided was the best focus for your class, and that changes every year. But those in the trenches know what DOES work, not only in theory, but in reality. Don't discount experience over recent classroom time. You won't win--and you can take that to any nurse manager.

We are good trained nurses while we are in college, and if anybody gives me a hard time as a new grad, I call that bullying, and will file a harassment law suit. Trust me!!!

You are well-trained students while in college, not nurses. A notable distinction. You are well-prepped to BEGIN LEARNING what it takes to become a good nurse. You have all the theories, all the well-supervised clinical time in place, you have spent lots of time practicing in VERY monitored settings. You will only learn if you are really a good nurse when you are working in the field, without the instructors overseeing your actions. You will find out how good you are when you are put to the test on a daily basis--not just for an actual test.

To suggest that anyone who gives you what you perceive to be a "hard time as a new grad" is bullying and harrassment (and makes you think lawsuit instead of 'how can I do better?) is really where you'll get into trouble as that new grad. The new grad or new nurse whose first thought is 'if they don't bend over and kiss my butt they're stupid and if they say anything to me I'm gonna sue' is not the nurse who will survive in this industry.

I'm glad your sister has hired you for a position you're excited about. Truly, the only thing you've said about the job that you find exciting is that she makes the schedules and you will earn a decent paycheck. Not sure if there's longevity in that, but I hope for your sake there is. I do worry, too, that when you find yourself defending actions made on the job (as you will, believe me, everyone does!), you will wrongly assume that everyone is out to get you and they are all wrong. Your sister getting you the job is nice, but if people believe that's the only reason you are hanging onto it, it will be very difficult for you.

Nursing is hard enough. Try to remember that there are those around you who ARE wanting you to succeed, but are NOT going to support your current mode of thinking. It doesn't make them bullies, it makes them wise.

I am not beating up the nurse manager, thank you very much for you insensitivity, and false accusation!! I am not that type of a person, and before you go accusing me, sounds like you are a professional at business hiring. I was not iquiring about your expertise perhaps in another are than nursing. Yes, maybe they NM ought to take a pay cut as well, it does not take 6 MN (one for each floor) to hire nurses to fill a hospital. Not more than it takes to hire someone with 3 years experience for the ICU compared to a new graduate, becuase they are training us really well here at the university, and there are a lot of us who are a lot more smarter than some nurses in the hospital now. Yes, that is right, we are being taught and are getting hands on the most updated nursing concepts and training there is. So, take that to your NM.

We are good trained nurses while we are in college, and if anybody gives me a hard time as a new grad, I call that bullying, and will file a harassment law suit. Trust me!!!

MN make too much money!!!!!

I don't think these attitudes and beliefs are going to be conducive to landing a new grad job. I hear you that you are frustrated, but you might want to examine some of your thoughts. Your comment about a "4 year RN" (BSN, new grad) being more valuable than an ADN nurse with experience is laughable. These beliefs and attitudes will be transmitted in interviews and the outcome may not be good for you.

Where is the best place to work if cleaning bodily fluids make you really queasy and uncomfortable?
Or is this something that any nurse must be able to handle?

Nursing isn't for you unless you can get over this.

Today, I carried away a bag (yes, a bag) of feces, helped clean another patient who soiled the bed x2, emptied 2 foley catheters of urine (multiple trips for each), suctioned my patients' mouths every two hours, did deep suction via ET tube every HOUR for one pt (dark yellow sputum), and every two hours for another (clear sputum).

On the pt with the clear sputum, I bathed him, changed his gown and bedding (since his skin is weeping so badly that it is felt through the glove and he gets multiple baths throughout the day), and did a dressing change including a wound that was weeping serosanguinous fluid.

My worst nursing day was taking care of a person with lower extremity wounds/ ulcers that had a wound so bad that I had to double-mask, gown and glove to treat. I spent over an hour on my knees in front of the pt (she wouldn't go to bed due to pain), and I could literally, on one leg, insert my hand between her calf and achilles tendon.

Nursing isn't pretty, and it isn't about money, and it isn't about "I think I can do it". Nursing is a career and a lifestyle all its own. It's either for you or not. Only you can decide.

I hear ya man. The thing of it is I guess, that even though nursing is a wide open field with lots of very varied specialties (flight nursing, community health, OB, OR, NICU, med/surg, assisted living, and on and on), we all (at least at my school) get trained as floor nurses for a Med/Surg unit. Not bad work mind you, just not at all what I want to do as a nurse. So I get frustrated when I feel like the emphasis is all on things I won't do in the real world or otherwise don't care about it, but I have also found that in the past, when I thought I was learing something stupid and pointless, sometime down the road, I often used that "stupid and pointless" knowledge. So I just keep plugging on and hope it will be the same here to, that even if I don't always know why it is important or care much about it, it may come in handy some day.
Keep on keepin' on.

As above. Educate and document response. However, one issue. If you have someone who is confused and who's sats are really falling you may have to take it do their face.
If someone wants to "write you up" (God I hate that phrase), just hand them the form and tell them to go ahead.

There is a recently posted thread here claiming that there are provisions sneakily inserted into the economic stimulus bill that would create all sorts of government controls on what treatments doctors could order for their patients. What you think of that is one thing. The fact that the initial article on which the thread is based is a complete fabrication - that's another thing entirely. Some people in that thread do a fair bit of debunking the original post, but the thread has grown so long so fast it's easy to miss them and I'm sure plenty of folks won't read that far, so I decided I'd start a new thread on the subject.
Why the lies? Because what is in the bill is some money to study - just study - the comparative effectiveness of various treatments and devices. Who doesn't want those studies done? Companies who make drugs and devices they secretly think might be overpriced and ineffective - that's who. And it turns out that the author of the original article referenced is on the board of directors and in the pay of at least one such company. Bingo!